LIBERTY DENTAL, INC (NPI# 1649516295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649516295 |
| Entity Type | Organization |
| Organization Name | LIBERTY DENTAL, INC |
| Practice Address |
112 W Adams St Havana IL 62644-1337 |
| Practice Telephone | 3095436301 |
| Practice Fax Number | 3095434958 |
| Mailing Telephone | 3095436301 |
| Mailing Fax Number | 3095434958 |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |
| Authorized Official Name | DR. AARON JAMES BLAKELY (PRESIDENT) |
| Authorized Official Telephone | 3095436301 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019024184 | IL | Dental Providers |
| Street Address |
112 W ADAMS ST |
| City | HAVANA |
| State | IL |
| Zip Code | 62644-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215096037 | Aaron James Blakely | Dentist | 112 W Adams St, Havana, IL 62644-1337 | 2006-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982771218 | Mason County Health Department | Clinic/Center | 1002 East Laurel Avenue, Havana, IL 62644 | 2006-11-30 |
| 1346206315 | Havana Hco, LLC | Skilled Nursing Facility | 609 N Harpham St, Havana, IL 62644 | 2006-04-26 |
| 1902849649 | Mason Hospital District | General Acute Care Hospital | 615 N Promenade St, Havana, IL 62644-1015 | 2006-06-13 |
| 1356307433 | Bruce Schultz | Family Medicine | 615 N Promenade St, Havana, IL 62644-1015 | 2006-04-26 |
| 1245296979 | Tad A Yetter | Internal Medicine | 615 N Promenade St, Havana, IL 62644-1015 | 2006-04-21 |
| 1427561489 | Brandi Nicole Behymer | Nurse's Aide | 320 N Plum St, Havana, IL 62644-1127 | 2017-11-13 |
| 1225032071 | R & Q Corporation | Pharmacy | 201 W Main St, Havana, IL 62644-1137 | 2005-06-09 |
| 1639655616 | Home Dialysis Therapies, Inc | Clinic/Center | 216 W Main St, Havana, IL 62644-1138 | 2018-07-12 |
| 1750382990 | Anthony Dale Roberts | Chiropractor | 303 W Main St, Havana, IL 62644-1139 | 2005-08-10 |
| 1962816868 | John Stinauer | Dentist | 312 W Main St, Havana, IL 62644-1140 | 2014-06-18 |
| Find all providers in zip 62644 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215096037 | Aaron James Blakely | Dentist | 112 W Adams St, Havana, IL 62644-1337 | 2006-12-07 |
| 1730201724 | Stinauer Family Dentistry Inc. | Dentist | 312 W Main St, Havana, IL 62644-1140 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.